<!DOCTYPE html>
<html>
	<head>
		<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
		<title>
			Registration Form
		</title>
		<link rel="stylesheet" type="text/css" href="style.css">
	</head>
	
	<body>
		<form method="get">
			<table border=1>
			
				<tfoot>
					<tr>
						<td colspan=4 class="center">
							<input type="submit" name="submit" value="Submit" />
							<input type="reset" value="Clear This Form" />
						</td>						
					</tr>
				</tfoot>
				
				<tbody>
					<tr>
						<td>
							<label for="last-name">Last Name</label>
						</td>
						<td colspan=3><input type="text" name="register" id="last-name" required="required" size="43" value="Todorova" placeholder="Ivanov"/>
						</td>					
					</tr>
					<tr>
						<td>
							<label for="first-name">First Name</label>
						</td>
						<td colspan=3>
							<input type="text" name="register" id="first-name" required="required" size="43" value="Asya" placeholder="Ivan" />
						</td>					
					</tr>
					<tr>
						<td>
							<label for="address">Address</label>
						</td>
						<td colspan=3>
							<textarea cols="32" rows="3" name="register" id="address" required="required" placeholder="01 Vitosha Bul. floor 1, apt.1">80 Cherni vrah Bul. floor 7, apt.6</textarea>
						</td>					
					</tr>
					<tr>
						<td>
							<label for="city">City</label>
						</td>
						<td>
							<input type="text" name="register" id="city" required="required" size="28" value="Pazardzhik" placeholder="Sofia" />
						</td>
						<td>
							<label for="state">State</label>
						</td>
						<td>
							<input type="text" name="register" id="state" required="required" size="5" />
						</td>
					</tr>
					<tr>
						<td>
							<label for="zip-code">Zip/Postal Code</label>
						</td>
						<td colspan=3>
							<input type="number" name="register" id="zip-code" required="required" size="10" value="1000" placeholder="1000" />
						</td>					
					</tr>
					<tr>
						<td>
							<label for="country">Country</label>
						</td>
						<td colspan=3>
							<select id="country">
								<option>Bulgaria</option>
								<option>Unated States of America</option>
								<option>Germany</option>
								<option>Other</option>
							</select>
						</td>					
					</tr>
					<tr>
						<td>
							<label for="telInput1">Phone (country code,<br /> area code, number)</label>
						</td>
						<td colspan=3>
							(+ 
								<input id="telInput1" type="tel" required="required" size="3" pattern="[0-9]{3}" value="+359" placeholder="+359"/>
							)
								<input id="telInput2" type="tel" required="required" size="3" pattern="[0-9]{2}" value="88" placeholder="11"/>
							-
								<input id="telInput3" type="tel" required="required" size="15" pattern="[0-9]{7}" value="8888888" placeholder="1111111"/>						
						</td>					
					</tr>
					<tr>
						<td>
							<label for="emailInput">E-mail</label>
						</td>
						<td colspan=3>
							<input id="emailInput" type="email" required="required" size="40" pattern="[a-zA-Z0-9_]{3,}@[a-zA-Z0-9_]{3,}.[a-zA-Z0-9_]{2,4}" value="asia@bulgaria.com" placeholder="email@domain.com"/>						
						</td>					
					</tr>
					<tr>
						<td>
							<label for="Month">Birth Date</label>
						</td>
						<td colspan=3>
							Month
								<input id="Month" type="date" required="required" size="2" pattern="[0-12]{2}" value="01" placeholder="01"/>
							Day
								<input id="Day" type="date" required="required" size="2" pattern="[0-31]{2}" value="12" placeholder="01"/>
							Year(4 digit)
								<input id="Year" type="date" required="required" size="4" pattern="[0-9999]{4}" value="1985" placeholder="1999"/>						
						</td>					
					</tr>
					<tr>
						<td>
							<label for="gender">Gender</label>
						</td>
						<td colspan=3>
							<select id="gender">
								<option>Male</option>
								<option>Female</option>
							</select>					
						</td>					
					</tr>
					<tr>
						<td>
							<label for="Spring">Starting date</label>
						</td>
						<td colspan=3>
							<input id="Spring" type="radio" name="Date" value="Spring 2006" />Spring2006
							<input id="Summer" type="radio" name="Date" value="Summer2006" />Summer2006						
						</td>					
					</tr>
					<tr>
						<td>
							<label for="comment">Comments/Questions</label>
						</td>
						<td colspan=3>
							<textarea cols="32" rows="6" name="register" id="comment" required="required" placeholder="Type your comments or questions here">Please send me more informatioin about the logging</textarea>
						</td>					
					</tr>
				</tbody>
				
			</table>
		</form>
	</body>
</html>